Individual provider Active NPI

Patricia M Couvillion, PH.D.

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1154338341
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20040357 Issued in IN
Practice address
10293 N Meridian St
Suite 375
Indianapolis, IN 46290-1123
Phone
(317) 581-2288
Fax
(317) 581-2295
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20040357 IN Primary

Addresses

Primary practice location

10293 N Meridian St
Suite 375
Indianapolis, IN 46290-1123

Mailing address

9240 N Meridian St
Ste 320
Indianapolis, IN 46260-1822
Phone (317) 844-7489

Other identifiers 1

IdentifierTypeStateIssuer
100128810AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110216001086 IN Practitioner - Clinical Psychologist 8325081243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health Associates IndyGroup PAC ID 4880136845, 7 clinicians

Practice addresses (Care Compare)

9240 N Meridian St
Suite 320
Indianapolis, IN 46260-1822
Phone (317) 844-7489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Health Associates Indy CurrentSince Mar 31, 2024 Accepting new patients

Locations

9240 N Meridian St
Ste 320
Indianapolis, IN 46260
Phone (317) 730-1662

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1154338341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9240 N MERIDIAN ST",
            "address_2": "STE 320",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601822",
            "telephone_number": "317-844-7489",
            "fax_number": "317-581-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10293 N MERIDIAN ST",
            "address_2": "SUITE 375",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462901123",
            "telephone_number": "317-581-2288",
            "fax_number": "317-581-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUVILLION",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100128810A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.